Impairment of tissue defenses by vasoconstrictors in vaginal hysterectomies
England, G.T.; Randall, H.W.; Graves, W.L.
Obstetrics and Gynecology 61(3): 271-274
1983
ISSN/ISBN: 0029-7844 PMID: 6337357 Document Number: 211211
This paper examines the role of vasoconstrictors, specifically epinephrine, as an etiologic factor in the impairment of the host's defense mechanism. One hundred patients were injected circumferentially around the cervix with a dilute solution of epinephrine before vaginal hysterectomy; these patients were compared to a control group of 100 patients injected in the same manner with a normal saline solution. This randomized prospective study shows that vasoconstrictors significantly predisposed the vaginal cuff surgical site to infection compared to the matched control group. This study shows also that the use of a vasoconstrictor did not significantly reduce blood loss. Based on these data, it is recommended that a locally injected vasoconstrictor not be used during vaginal hysterectomy.